Cervical pregnancy: Diagnosis and management options
Ectopic pregnancy is associated with significant morbidity and mortality in the first trimester. With in vitro fertilization and better early diagnosis, the incidence of ectopic pregnancies has increased. Although cervical pregnancies are <1% of all ectopic pregnancies, they could be associated with life-threatening bleeding. Transvaginal ultrasonography is the mainstay of diagnosis of cervical pregnancy, but beta-human chorionic gonadotrophin may be helpful in monitoring treatment outcomes. Current therapeutic options for cervical pregnancies include conservative management which could be medical, surgical or both, and 'radical' surgery. The advent of real-time transvaginal ultrasound examination has allowed earlier diagnosis which has in turn permitted life-saving and fertility-sparing treatment options. Various conservative haemostatic measures may be used if bleeding occurs during conservative management. Clinicians should watch carefully for a possible increased
risk of preterm labour or incompetent cervix, while reassuring patients that most pregnancies after a cervical ectopic will lead to term deliveries.
Keywords: cervical pregnancy, transvaginal ultrasonography, methotrexate
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